Retracted: Long‐term efficacy and safety of blonanserin in patients with first‐episode schizophrenia: A 1‐year open‐label trial

Abstract

Aims:The purpose of this study was to evaluate the long-term effectiveness and safety of blonanserin, a second-generation antipsychotic drug developed in Japan, in patients with first-episode schizophrenia.Methods: Twenty-three antipsychotic-naïve patients with first-episode schizophrenia were treated within an open-label, 1-year, prospective trial of blonanserin (2-24 mg/day). Clinical evaluations were conducted at baseline and 2, 6, and 12 months after the start of treatment. The main outcome measures were changes in subjective well-being and subjective quality of life, as assessed by the Subjective Well-being under Neuroleptic treatment scale Short form-Japanese version and the Schizophrenia Quality of Life Scale-Japanese version, respectively. Secondary outcome measures included the Positive and Negative Syndrome Scale, the Brief Assessment of Cognition in SchizophreniaJapanese version, laboratory tests, bodyweight, and extrapyramidal symptoms.Results: Fourteen patients (60.9%) remained on the study at 1 year. In the intention-to-treat analysis, significant improvements were observed in several subscales on the Subjective Well-being under Neuroleptic treatment scale Short form-Japanese version, the Schizophrenia Quality of Life Scale-Japanese version, and the Brief Assessment of Cognition in Schizophrenia-Japanese version, and in all factor scores on the Positive and Negative Syndrome Scale. Improvement in depressive symptoms with blonanserin treatment was positively correlated with improvements in subjective well-being and subjective quality of life, as well as verbal memory. No significant changes were noted for any safety measure during the 1-year study period. Conclusions:Blonanserin was well tolerated and effective for the treatment of first-episode schizophrenia in terms of subjective wellness, cognition, and a wide range of pathological symptoms. Further largescale studies are warranted to confirm our findings.Key words: blonanserin, cognition, first-episode schizophrenia, second-generation antipsychotics, subjective well-being. SCHIZOPHRENIA IS A chronic and debilitating disorder characterized by positive, negative, cognitive, and affective symptoms. Second-generation antipsychotics (SGA), excluding clozapine, are currently recommended in many guidelines as firstline agents for acute and maintenance therapy for schizophrenia. In four randomized, short-term, double-blind trials in patients with chronic schizophrenia, 3-6 blonanserin was shown to be as effective as haloperidol and risperidone in improving positive symptoms, and superior to haloperidol in improving negative symptoms. The overall safety profile of blonanserin Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan. Email: y2ninomiya@marianna-u.ac.jp Received 25 December 2013; revised 19 April 2014; accepted 11 May 2014. R e t r a c t e dhas been similar to that of haloperidol and risperidone, 3,4,6,7 but blonanserin has been associated with a lower incidence of extrapyramidal symptoms (EPS) than haloperidol. 3,8...

A randomized trial of aripiprazole vs blonanserin for the treatment of acute schizophrenia and related disorders

“…Moreover, blonanserin improved impairments in verbal fluency and executive function as well as work skills 11. Another 1-year, open-label study reported that blonanserin improved psychotic symptoms as well as depressive symptoms, and the reduced depressive symptoms were associated with enhanced subjective well-being, subjective quality of life, and verbal memory 12. Moreover, no significant changes were shown in any safety measures, such as extrapyramidal and cardiometabolic symptoms, during the study 12.…”

“…Another 1-year, open-label study reported that blonanserin improved psychotic symptoms as well as depressive symptoms, and the reduced depressive symptoms were associated with enhanced subjective well-being, subjective quality of life, and verbal memory 12. Moreover, no significant changes were shown in any safety measures, such as extrapyramidal and cardiometabolic symptoms, during the study 12. These results suggest that, like aripiprazole, blonanserin can be used as a first-line antipsychotic for the treatment of schizophrenia.…”

Atypical antipsychotic properties of AD-6048, a primary metabolite of blonanserin

“…Blonanserin also alleviate positive and negative symptoms with similar doses of HAL in patients with schizophrenia (Garcia et al, 2009;Tenjin et al, 2013;Hori et al, 2014;Ninomiya et al, 2014). In addition, blonanserin shows atypical antipsychotic properties with a lower propensity to induce EPS both in animals and humans.…”

“…In addition, blonanserin improved PCP-induced depressive behaviors (e.g., immobility in the forced swim test), a predictive model for negative symptoms, and PCP-induced cognition impairments (Nagai et al, 2003;Horiguchi and Meltzer, 2013;Hida et al, 2015). Recent clinical studies also showed that blonanserin ameliorated cognitive deficits, as well as positive and negative symptoms, in patients with schizophrenia (Garcia et al, 2009;Tenjin et al, 2013;Hori et al, 2014;Ninomiya et al, 2014).…”

Comparative Effectiveness of Blonanserin and Paliperidone in 93 In-patients with Acute- to Maintenance-phase Schizophrenia

“…The dose levels used in this study were lower than those reported thus far, although the focus was on acute phase, and this was attributable to the fact that the study enrolled patients who had good baseline (pre-onset) social function but who relapsed because of poor drug adherence and non-compliance and hence had no residual effects of their prior treatment or who were patients experiencing their initial onset of the disorder, and that patients with medication-resistant hallucinations/ delusions were not enrolled. Ninomiya et al [16] studied the long-term efficacy/safety of BNS in initial-onset schizophrenia patients, and reported that the mean dose level was 2.9 mg/day at treatment initiation and 5.6 mg/day during 1 year of treatment. Moreover, Üçok et al [25] reported that they used a PAL dose level of 6.42 mg/day for initial-onset schizophrenia patients, which was a dose similar to the PAL dose level used in this study.…”